PHILIP A JORGENSEN Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149005269

License Status

NOT RENEWED

Business

First Name

PHILIP A

Last Name

JORGENSEN

Business Name

PHILIP A JORGENSEN

Original Issue Date

02/02/1993

Effective Date

09/14/2009

Expiration Date

11/30/2011

City

DIXON

State

Zip

61021

County

LEE

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

01/05/2012